Provider First Line Business Practice Location Address:
1000 E 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OWENSBORO
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42303-3323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-683-1571
Provider Business Practice Location Address Fax Number:
270-926-4619
Provider Enumeration Date:
06/10/2009